Diverticulosis refers to herniation (out pouching) of the inner lining of the colon through the muscle layers of the colon causing pouches or pockets. Over half of Americans over the age of 50 have diverticulosis.
What causes diverticular disease?
With advancing age, the colon wall weakens and the increased pressure within the colon causes herniation of the inner lining. Normally the colon contracts in a wave like manner to expel feces; when the stools are hard and less bulky, greater pressure is required to move the stools resulting in high intracolonic pressure and thus diverticulosis. With high fiber intake, the stools are bulkier and soft and easy to expel.
What are the symptoms of divertuculosis?
Most patients experience no symptoms. A few may develop left lower quadrant abdominal pain due to the high intracolonic pressure and contractions. Uncomplicated diverticulosis does not produce bleeding, fevers etc.
What are Complications of Diverticulosis?
The two main complications of diverticular disease are:
- Bleeding: Usually caused by erosion of a vessel at the base of the diverticulum. The bleeding is usually red and often requires transfusion.
- Diverticulitis: When there is a microperforation at the base of a diverticulum, diverticulits results. The symptoms are fever, LLQ pain and tenderness. The condition is best diagnosed by blood tests and CT Scan and treatment requires antibiotics. At times surgery is required.
How is Diverticular Disease Diagnosed?
Diverticular disease is diagnosed by either Barium Enema or Colonoscopy. Since barium enema is obsolete it is primarily diagnosed during colonoscopy. The main reason for performing these tests is to exclude other conditions such as cancer, colitis and polyps.
How can Diverticulosis prevented?
There are several ways to prevent the development of diverticulosis and control some symptoms associated with it.
- Increase fiber in the diet (Insoluble fiber). This would include eating fruits and vegetables with intact Skin, salads, vegetables, whole grain cereal.
- Soluble fiber: Metamucil, Citrucel, Konsyl, Benefiber are good sources of soluble fiber
Some physicians suggest avoiding nuts, popcorn, fruits with seeds etc to prevent diverticulits but these have measures have NOT proven to be useful. Almost 50-70% above 50 years of age have diverticulosis and they all are eating nuts but not experiencing diverticulitis which tells us that nuts are okay to eat - please enjoy eating tomatoes, corn, nuts etc.